Eczema, also known as atopic dermatitis, is a chronic inflammatory skin disease characterized by itching, redness, dryness, and cracking. Eczema can occur in people of all ages, but is most common in children. Eczema often occurs in cycles, with flare-ups and remissions.
Types of Eczema :
1. Atopic Dermatitis:
- most common eczema, associated with allergies, asthma or hay fever.
2. Contact Dermatitis: -
- Irritant Contact Dermatitis: caused by direct skin contact with an irritant (soap, chemical, etc.).
- Allergic contact dermatitis: caused by allergic reactions to substances such as nickel, perfumes, poison ivy, etc.
3. Dyshidrotic eczema: small itchy blisters on the hands and feet.
4.Coinoid eczema: mostly on legs, arms, or torso,
5. Seborrheic dermatitis: scaly, greasy patches on the scalp, face, or chest;
6. Stasis dermatitis: stasis dermatitis: occurs on the lower extremities due to poor circulation and fluid buildup;
causes :
The exact cause of eczema is unknown, but a combination of genetic, environmental, and immune factors are involved. Common triggers include:
- Irritants Irritants: soaps, detergents, fragrances, or certain fabrics.
- Allergens Allergens: pollen, dust mites, pet dander, or certain foods.
- Environmental factors: cold, heat, humidity.
- Stress: Can aggravate symptoms.
- Heredity: Family history of eczema, asthma, or hay fever increases risk.
- Immune system dysfunction: overreaction to external stimuli.
Symptoms -
Itching: often intense, especially at night.
Red or brownish-gray spots: often on hands, feet, ankles, wrists, neck, upper chest, eyelids, elbows, or inner knees.
Dry, cracked skin: may bleed or fester.
Thickened skin: from prolonged scratching or friction.
Liquid-filled blisters: may ooze and crust over.
Diagnosis:
- Eczema is usually diagnosed by: Based on the appearance of the skin.
- Medical history: includes allergies, asthma, family history of eczema.
- Patch test: identifies specific allergens if contact dermatitis is suspected.
- Skin biopsy: In rare cases, to rule out other conditions.
Treatment:
There is no cure for eczema, but treatment is aimed at managing symptoms and preventing flare-ups:
1. Topical treatment:
- Moisturizers (emollients): keep skin moist and protect barrier function.
- Corticosteroid creams or ointments: reduce inflammation and itching.
- Calcineurin inhibitors(e.g., tacrolimus, pimecrolimus): for sensitive areas such as the face.
2. Oral medications: -
- Antihistamines: for nighttime itching;
- Systemic corticosteroids:Used for severe flare-ups.
- Immunosuppressants(e.g., cyclosporine, methotrexate): for severe, refractory eczema.
3 Biological therapies: -
- Dupilumab (Dupixent): monoclonal antibody for moderate to severe atopic dermatitis.
4 Lifestyle and home therapy: -
- Warm bath: after warm bath, Apply moisturizer immediately after warm bath.
- Wet wrap therapy: After applying the medication, wrap the skin with a wet bandage. -
- Avoid triggers: Identify and eliminate allergens and irritants.
5. Phototherapy: -
- Controlled exposure to ultraviolet light.
Complications :
- Infections: - Scratching and skin breakage can lead to bacterial, viral, and fungal infections.
- Chronic itching and scratching: can lead to lichenification (thickened, leathery skin).
- Sleep disturbances: Severe itching may affect sleep.
- Psychological effects: stress, anxiety, depression.
Prevention :
- 1. Regular moisturizing: use a thick cream or ointment after bathing;
- 2. Avoid harsh soaps and detergents: use fragrance-free, non-irritating products;
- 3. Wear soft, breathable fabrics: cotton, etc.;
- 4. Stress management: practice relaxation techniques such as yoga and meditation;
- 5. Allergy management: avoid allergens and keep living conditions free of dust mites and pet dander;
prognosis:
- Many children will outgrow eczema by puberty, but others will experience periodic recurrences throughout their lives.
- With proper treatment and prevention strategies, most can effectively manage their symptoms and lead comfortable lives.
